Transfusion apparatus



P 1941- R. A. BUTLAND 2,254,994

TRANSFUSION APPARATUS Filed Nov. 6, 1959 2 Sheets-Sheet l Sept. 2, 1941.

Filed Nov. 6, 1939 2 Sheets-Sheet 2 11th): was

Patented Sept. 2, 1941 UNITED Q STATES PATENT OFFICE TRANSFUSIONAPPARATUS Ralph A. Butland, Lowell, Mass. Application November 0, 1939,Serial No. 303,159

3 Claims.

This invention relates to methods and apparatus for the administrationof fluids into the blood stream and for treatment of the fluids while intransitthrough the apparatus.

' In the administration of any fluid into the blood stream, whether thefluid be blood or any other therapeutic addition, it is necessary thatthe fluid be kept at the proper temperature, and that it flow into theblood stream of the recipient at an accurately controlled rate, and thatthe desired amount of fluid be introduced. The infusion of fluid into arecipient in too great amounts, at improper temperatures, or atan-improper rate will result in serious shock and injury to the patient.It is, therefore, a fundamental object and purpose of. my invention toprovide in a practical apparatus an arrangement .whereby theadministration of fluids into the blood stream may be controlled in arelatively simple and efflcient manner.

It is becoming increasingly evident in the practice of therapy thatdiverse malignancies and diseases may be treated with salutary effect bythe infusion of therapeutic additions into the blood stream. Suchadditions may simply consist of citrated blood, or of citrated bloodcombined with therapeutic additions of various kinds which may be foundadvantageous, or solely of a therapeutic addition. As the practice ofinfusing compositions into the blood stream becomes more common in thetreatment of a great many malignancies and diseases, it is apparent thatthe need for practical apparatus affording the attending surgeoncomplete operative control of the various phases of the administrationis pressing.

I am aware that there are now in use various apparatus and methodswhereby transfusions of the general type referred to may beadministered.

However, in many such apparatus pressure means are utilized to urge thefluid into the blood stream of the recipient so that, in a bloodtransfusion, for instance, the corpuscles of the blood are injured bythe pinching action of the compressor. Also, in the apparatus now knownto me eflicient and automatic means for controlling the temperature ofthe fluid at all stages of its course through the apparatus are lacking,and even in the simplest transfusion the process of infusion must oftenbe halted to test and ascertain the temperature of the fluid.Furthermore, means are not always provided to permit the attendingsurgeon to effectively measure and control the quantity of the additionbeing infused into the of a transfusion require the greatest degree ofaccuracy if the administration is to be a success, it is, therefore,highly advantageous and desirable to have each of them regulated in asingle compact unit for control by the practitioner. I.

have provided such an apparatus comprising either a mobile or stationarysingle compact unit where certain 'of the controls are preferably butnot necessarily automatic in their operation and other controls areadapted for manual control and regulation by the attending surgeon, allof such controls being under the direction and inspection of theoperator of the apparatus.

The apparatus which I have devised may be used with efllciency andaccuracy either in direct or indirect transfusions, and. in transfusionsof various kinds which are continuous during one or The present dayexternal treatment of malig nancies by X-ray has produced excellentresults, however, it is now believed that such may be successfullytreated by and through the infusion of therapeutics into the bloodstream of a patient. It is within the scope of my invention to treatsuch malignancies by the infusion of specially treated therapeuticagents into the blood stream of the recipient. I have combined in myapparatus for cooperation therewith means to treat the blood or othertherapeutic agents or radioactive substances, or any combinationsthereof which may at the particular time be disposed in my apparatus,with a stream of cathode or other rays in the presence of, near orbefore electric discharge tubes, high frequency power or high tensiondischarge tubes, Coolidge tubes, Penetrans tubes, water-cooled tubes,split cathode tubes, X-ray therapeutic tubes, ultra-violet rays, and anyand all kinds of rays, ray emanations and the like. It will be clearfrom the specific description of my invention to follow that theapparatus may be used in such manner as to bombard the fluids containedtherein with any of the various types of rays mentioned, or with otherdesirable rays, or to use my apparatus in blood stream of the recipient.Asall such phases the administration of transfusions without the raytreatment, all being under the control and specific wishes of theattending surgeon. It will be evident that the apparatus of thisinvention is of such flexible nature that a great diversityofcombinations of therapeutic agents may be used, or such different agentsmay be infused singly, alternately, and in various combinations, thetemperature, quantity, relative proportions, rate of infusion, and thecontrol for all such aspects disposed within access for facileregulation by the attending surgeon. The infusion of therapeuticassistants into the blood stream of a patient by such means as I haveinvented presents a wide field for experimentation in the treatment of adiversity of diseases and malignancies, and it is, therefore, afundamental object of my invention to provide a compact apparatus for acontrolled therapy of this broad t is my purpose to provide an apparatuswhich may be used in the simplest routine therapy as well as in the mostcomplex therapy. The routine direct blood transfusion, for instance, maybe administered by the adaptation of my apparatus to receive the donorsblood and for the addition thereto of an anticoagulant. The apparatusmay likewise be adapted with the greatest facility to administer acomplex infusion of a variety of therapeutic agents over a relativelylong period of time, each and all of which are under the positivecontrol of the attending surgeon.

With the foregoing general objects, features, and results in view, aswell as certain others which will be apparent from the followingexplanation, the invention consists in certain novel features anddesign, construction, mounting and combination of elements, as willbe-more fully and particularly referred to and specified hereinafter.

Referring to the accompanying drawings in which similar referencecharacters refer to corresponding parts throughout the several figuresthereof:

Fig. 1 is a front elevation of the preferred form of my invention with aportion thereof shown in section.

Fig. 2 is an end elevation of the preferred form of my invention with aportion thereof shown in section.

Fig. 3 is a section taken on line 33 of Fig. 1.

Fig. 4 is a section taken on line 4-4 of Fig. 1.

Fig. 5 is a front elevation of a modified form of my invention.

Fig. 6 is a front elevation of a further embodiment of my invention.

Fig. 7 is a detailed View of a modification of my invention. I

In Figs. 1 and 2 of the drawings I have disclosed by way of example andnot as a limitation one form of my invention in which the apparatus isshown as a single compact unit mounted upon a mobile stand or frameworkwhich comprises a base or platform I having vertical supporting legs 2of any desired number, and a forwardly projecting horizontal shelf 3mounted on the legs 2 a substantial distance from the lower end thereof.A vertical panel 4 is mounted on vertical supporting members 5 spacedforwardly from.- the legs 2 and extending upwardly from the shelf 3.Horizontal supports 6 are provided connecting the upper ends of thesupporting members 5 with the legs 2. A panel I is mounted on the legs 2and extends therebetween and is formed with an apron portion forming ahorizontal shelf 8 mounted on the supports i. In

order to provide a mobile unit the legs 2 may be mounted on casters 9.The framework, panels, and shelves are preferably made of stainlesssteel or the like metal so that the'various parts thereof may be easilycleaned and will stand severe usage. It is to be understood that while Ihave disclosed the framework upon which the apparatus is supported asbeing mobile that it may well consist of a stationary framework whichmay be mounted by various means upon a wall or the like, or in anydesired position, and furthermore the arrangement of shelves, panels andthe like which I have shown are not to be considered as of a limitingnature, as it is within the scope of my invention to provide variousarrangements of shelves, panels, supports and the like adapted toprovide the most useful and convenient disposition thereof to suit theparticular installation.

A combined container rack and tank unit II is disposed transversely ofthe panel 1 adjacent the top thereof and above the shelf 8, which rackand tank is secured to the panel by any suitable means, such as rivets Hor the like. The container rack is formed of metal, such as "Monelmetal, and is preferably though not necessarily lined with copper, andis designed to constitute a leakproof casing or tank adapted to receivea heating medium therein, as well as to constitute a rack for receivingone or more containers II, the temperature of the contents of which isto be controlled. While I have disclosed the combined container rack andtank as receiving a straight row of containers l2 it is within the scopeand conception of my invention to provide such a unit which is ofcircular, semicircular, or of any other advantageous formation. Itis tobe understood, of course, as hereinbefore pointed out that if adifferently shaped container rack and tank is used the panel andframework construction upon which the rack and tank is supported couldlikewise be altered if necessary to properly support the combined rackand tank. The combined container rack and tank III is adapted to receivetherein a heating medium which may be either liquid or gaseous and is soconstructed as to substantially envelop each of the containers supportedtherein for transferring heat from the heating medium thereto. Thecontainer rack and tank which may be designed to support any number ofcontainers is formed to provide various compartments or portions throughwhich the heating medium is adapted to circulate for transferring heatby convection to the containers and hence to the contents thereof. Thecontainer rack and tank Hicomprises a rear transversely disposedcompartment I3, the front wall of which is formed to providetransversely spaced curved container receiving and surrounding sections,each of which is curved downwardly and forwardly to provide a largerlower portion which is particularly disclosed in Fig, 3 of the drawings.Between each container receiving section is a channel l4 formed by thewalls of the container receiving. section and adapted to receive aheating medium to be circulated therethrough. The channels l4 are formedat their forward portions to provide vertically disposed compartments I5spaced one from the other to provide longitudinal slot-like openings orrecesses l6 extending between the vertical walls of the compartments l5.As will be apparent by this particular construction of combined rack andtank I have provided a container supporting and heating arrangementhaving recesses therein for receiving the containers whereby eachcontainer is substantially encircled by members thrqugh which a heatingmedium flows to insure emcient transfer of heat from the heating mediuminto the container to accomplish the desired result. As the channels areopen to the rear transverse. compartment for communication therewith andthe vertical forward compartments are open with respect to the channels,it is, therefore, clear that the heating medium disposed within the tankwill circulate freely through and into each of the various compartmentswhich constitute the tank structure.

The combined container rack and tank unit I. which is adapted to receivefor circulation therethrough any desired type of heating medium such asoil, is provided with an oil or other heating medium outlet ll disposedat the upper portion of one end of the tank, and is also provided withan oil inletl8 disposed at the lower portion of the opposite end of thetank from the aforementioned oil outlet. For removal of warmer oil orheating medium from the upper portion of the tank I provide a pipe I!opening into the tank at the outlet I1 and secured therein by anysuitable means, which pipe jglsxtends from the'said oil outlet to amotor driven pump unit 20 which is disposed on a shelf 2| mounted on andextending between the legs 2 and the supporting members 5 of theframework. An oil inlet pipe 22 extends from the pump unit to theoilinlet opening in the tank In in which it is secured by any suitablemeans. One or more electric heating elements 23 of any desired type aredisposed within the tank It), preferably adjacent the bottom thereof forimmersion within the oil or other heating medium and are connected into-any desirable electric circuit for automatic operation through themedium of a bulb type thermostat 24 or any desired type of thermostat,the thermostat disposed to extend into the oil or other heating mediumwhich is within the tank Ill. Thermo-. stat setting or adjusting means24' are disposed on the rear side of the panel 1 for actuation by theoperator of the apparatus. It will, therefore, be evident that upon theproper setting of the thermostat the temperature of the oil or otherheating medium with which the tank I is filled will at all times beautomatically controlled by the action of the thermostat which willoperate to open or close the electric circuit to the heating elements23, depending upon the temperature of the hetaing' medium within thetank. In order to assure the proper circulation of the heating mediumthroughout the various compartments which constitute the combinedcontainer rack and tank so as to evenly distribute the heating mediumrelative to the containers l2 supported therein, the motor driven pumpunit is operated at any. desired periods to with-- draw warm oil whichhas risen to the top of the tank by convection from the upper outlet llthrough the pipe l9 to the pump 20 and through the return line 22 to thelower portion of the tank; thus substituting the cooler oilin the bottomof the tank for warmer oil. While I have disclosed this particularmethod of controlling, heating, and circulating the oil or other heatingmedium within the tank it is apparent that any desired method andapparatus may be utilized for this purpose, for instance, .if air isbeing used as the heating medium it may be circulated through the tankl0 and the various compartments thereof by means of a fan or blower, or

a liquid heating medium may be agitated to circulate through the tank bymeans of an im- I peller or, the like, and, it is, therefore, to beunderstood that I do not intend to limit my invention by the disclosurein the drawings of this particular apparatus for heating, controlling,and circulating the heating medium disposed within the combinedcontainer rack and tank.

As hereinbefore explained and pointed out it 10 is essential for theproper and successfuladministration of blood or of any therapeutic agentinto the blood stream that the temperature of the addition or additionsthereto be properly and accurately controlled. A further requisite forthe proper administration of fluids and combinations-of fluids into theblood stream is that the proper'amount and proportions of each beinfused and that they .be transferred at the proper rate. If theserequirements are not followed carefully serious consequences to therecipienlpf he fluid will likely occur.- For receiying and storing forindefinite periods blood on-therapeutic agents orthe like, and forcontrolling the temperature thereof'and the proportions thereof whichare being dispensed, I provide a container l2 which may be made of glassor may be constructed of any other desirable material. This container isdisclosed in the drawings as constituting a member formed of glass andhaving a rear wall 25 curving downwardly and forwardly, and the frontvertical wall of which is provided with a longitudinally extendingforwardly projectinghollow rib 26 extending from the top of thecontainer to a point spaced from the bottom thereof, where the saidfront wall is bent forwardly at an angle to provide a forwardlyprojecting lip 21 which is complementary to the rear wall 25 at itslower portion, both of these walls being drawn to provide a forwardlyprojecting downwardly curved drainage nipple 28 for the dispensing offluid from the container. While the nipple 28 is not .shown as having astopcock associated therewith it is within the scope of my invention topro- 5 vide one if desired. Such a stopcock would prevent drainage fromthe container to allow it with the contents thereof to be portable. Eachcontainer I2 is provided with a removable top 21 having a screen 28'seated on shoulders within the container l2 in which gauze or the likematerial 28" rests. If necessary the top may have minute openingstherein.

The containers l2 are adapted to receive the blood or therapeutic agenttherein for retaining at the proper temperature by means of the heatingmedium which is disposed within the tank II) for circulation about thecontainers. The containers have been designed to present a structureaiding in the transfer of heat from the heating medium to the contentsthereof. The

downwardly and forwardly curved rear wall of the containers produce anarrow or relatively reduced portion to render the transfer of heat tothe contents of the container more effective.

The hollow forwardly projecting longitudinally disposed rib 26 isprovided with metric calibrations 29 extending from the top to thebottom thereof and adapted for observation and reading by the attendingsurgeon for determining the 7 amount of fluid being dispensed fromwithin each individual container. Reference particularlyto Fig. 1 of thedrawings discloses the disposition of a plurality of containers withinthe combined container rack and tank unit for the measured 75 dispensingand heating of the contents of the containers. The projecting hollowribs of each containerxare adapted to slide into the longitudinalslot-like openings l6 between the compartments l of the tank and to lieflush with the front faces of each of these compartments so that theattending surgeon may with the aid of the calibrations on the ribsmeasure the quantity of fluid removed from each container. It is clearthat the containers are so designed that the fluid will, of course, bewithin the hollow rib as well as within the container bodies themselves.The containers are supported within the combined container rack and tankin engagement with and between the rear transverse compartment l3 andthe compartments I5 which retain them against forward movement. Lateralmovement is prevented by means of the connecting fins or channels l4.Because of the particular construction it is to be noted that thecontainers seat on the curved wall of the rear compartment. Thus, I haveprovided a combined rack and tank which so supports each container thatit is substantially enveloped and surrounded by the various compartmentsthrough which the heating medium is circulated for heat transfertherefrom to the contents of the containers.

While in the particular embodiment of my invention which I havedisclosed in Figs. 1 and 2 of the drawings I have shown a combined rackand tank for holding five containers it is within my conception andclearly within the scope of my invention to provide such a rack and tankwhich will accommodate any desired number of containers, and,furthermore, while I have disclosed a container of a particularconfiguration it is to be understood that containers of various shapesand sizes may be utilized, and when such variably shaped containers areused the combined container rack and tank will be shaped to conformthereto.

For dispensing the fluids within the containers I provide rubber tubing30 which is connected to the nipples 28 and extends downwardly to andthrough sleeves 3|" which are mounted on the shelf 8 which is aperturedbeneath each sleeve for the passage of the rubber tubing therethrough.The sleeves 3|, one of which is provided for each container, have,threaded holes therein for receiving screws 3|" having plates or diskson the inner ends thereof for compressing or pinching engagement withthe tubing when the screws are turned to thereby pinch the tubing to cutoff or retard the flow of fluid from the container l2 and through thetubing. The tubing 30 may consist of double walled rubber hose or oflengths of rubber tubing combined with glass tubing in order to retainthe heat of the fluid from the container as it passes therethrough to anelement of the apparatus which is about to be described.

A collecting cell or multi-fuser 3| is mounted preferably at an angle onan adjustable bracket 32 which is secured within a suitably linedboxlike casing 33 which is mounted upon the horizontal shelf 3. Themulti-fuser casing 33 is provided with a series of any desirable numberand type of removable filter panels 34 set at an angle and forming thefront side of the multi-fuser casing. Suitable means are employed formount ing the panels 34 on the casing. Any desirable number ofelectrical heating elements 35 are disposed within the multi-fusercasing, the heating elements being automatically energized anddeenergized through the action of a thermostat 36 which is shown as oneof the capillary bulb type but which may be of any known or desirableform. This thermostat is mounted within and adjacent to the multi-fuser3| and is connected to a control box 31 which is mounted on the rearside of the panel 4 externally of the casing for control by theattending surgeon. The casing 33. which is mounted upon the shelf 3 at aposition forwardly of and disposed below the combined container rack and-tank I5, is provided with a plurality of apertures 33' for receivingtherethrough'the tubing 30 extending from the nipples of the containers.It is to be understood that any number of apertures may be provided, thenumber depending upon the number of containers which are being used. Therubber tubing extends into the casing 33 for connection with nipples 33which are formed upon the collecting cell or multi-fuser 3| which ispreferably formed of glass, and is preferably, though not necessarily,of heart shape. The number of nipples 33 extending from the muiti-fuseris dependent upon the number of tubes 30 extending into the casing forconnection with the multifuser. It is apparent that the apparatus isendowed with great flexibility as the number of containers may be variedand the number of connections into the multi-fuser may, of course,likewise be varied. Metric calibrations 40 corresponding to thoseprovided on the containers i2 are formed on the front face of themulti-fuser for visibility from an external position with relation tothe casing 33. A thermometer 4| is mounted adjacent to the front face ofthe multifuser for visibility from outside the casing. A.

ground glass nipple providing a stopcock 42 is provided at the lowerportion of the multi-fuser for drainage of the contents thereof and anaperture 43 is formed in the casing directly below the outlet "42 forthe passage therethrough of rubber tubing 44 which is secured to thenipple 42. A clamp 45 of any desired type may be associated with therubber tubing 44 at any advantageous position therealong, to control theflow of fluid from the'multi-fuser instead of the stopcock l2.

With. one or more containers |2 in position within the combinedcontainer rack and tank l0 and with the screws or compressors 3|" inreleased open position to allow the gravity flow of fluid from thecontainers through the tubing 30 into the collecting cell, and with thestopcock l2 and clamp 45.0pe it, will be apparent that the fluid withinthe containers l2 will flow therefrom through the multi-fuser and intothe tubing for infusion into the blood stream of a patient through aneedle which may be attached to the free end of the tubing 44.

In order to retain and control the heat of the fluid within themulti-fuser 3| the thermometer 4| associated therewith permits theattending surgeon to know what the temperature is within the casing 33,and due to the automatic control by means of the thermostat 36 theheating elements 35 will be turned on and off to control the temperaturewithin the container 33 to thereby regulate and retain at the propertemperature the fluid within the multi-fuser 3|.

By means of the calibrations which are externally visible on thecontainers l2 and on the multi-fuser 3| the attending surgeon may bymeans of the individual compressors 3|" regulate the rate of flow andthe proportionate quantity of fluid dispensed from each of thecontainers l2 into the multi-fuser, and may regulate by means of thestopcock control 42 and clamp 45 and acena variable with thepathological condition ofthe patient. Reference particularly to Fig. 2of the drawings discloses one form of such means wherein the numeral 46designates an adjustable X-ray tube disposed in any suitable manner toproject a cathode stream into the casing 33 through the fllter panels 34to thereby bombard and effectively treat the fluid contents of thecollecting cell or multi-fuser 3|.

As examples of some from among several combinations of irradiablematerials and activating rays which may be used in a manner as abovedescribed, I present the following-Salvarsan of proper strength and therequired milliliters added to a suitable measurement of human bloodwhich has been previously treated with sodium citrate and this treatedwith a cathode stream from a hard X-ray tube. The stream of cathode raysmay be'filtered through requisite millimeters of copper, aluminum, orother fllter substances. As a further example-to a suitable measurementof sodium chloride and citrated blood may be added the requiredmilliliters of iron and ammonium citrate, and sodium phosphate, and thistreated with any of the visible or invisible rays of the spectrum,ranging from the long infra-red rays to the short ultra violet, rays.

For connecting the entire apparatus into an electric circuit I provide aplug and electric cable 49 entering the apparatus at any convenientpoint, and an electrical control board 50 is disclosed mounted on therear side thereof.

The apparatus as disclosed in Figs. 1 and 2 of the drawings allows greatlatitude to the surgeon in the controlled and selective administrationof fluids to a patient. Each container l2 may, in a relatively complextherapy, hold a different therapeutic composition which is to be infusedafter mixing in certain proportions and after treatment, into thepatients blood stream. Accurate control of the proportion of fluiddrained from each container is accomplished by observation of the scalethereon and by operation of the compressors 3|". Alternate infusions offluids from separate containers may be administered by controlleddrainage from one container at a time. By gravity flow the relativequantities of fluid from each container drains into themulti-fuser forcombination therein and'treatment if desired by electrotherapy, as, forinstance, by means of the X-ray tube 46. Drainage from the multi-fuserto the patient is by gravity and is controlled by the cook 42 and/or bythe clamp 45. It is seen that the entire fluid flow is by gravity, whichprovides sufllcient head due to the arrangement and design of the entireapparatus.

In certain cases it may be desirable not to make.

use of the multi-fuser. In such instances the rubber tubing 30 will notbe run into the casing for connection to the multi-fuser but insteadwill be free to discharge the fluid from a container as and wheredesired.

With the transfusion apparatus as described the containers may be filledunder sterile conditions and all of the connectingmedia properlyattached, whereupon the apparatus may be moved direct to the patient forthe infusion, the connecting plug 49 merely being connected into aconvenient electric circuit. The infusion then continues under theobservation and control of the attending surgeon who merely has to setthe thermostatic controls, observe the calibrations and regulate thevalves for controlling the rate of flow and the proportionate quantityof fluid draining by gravity from each container and from themulti-fuser.

Another form of my apparatus is disclosed particularly in Fig. 5 of thedrawings. In the descriptionof the modifications of my invention thesame-numerals will be used to designate similar elements of theapparatus to those which have heretofore been described in connectionwith the preferred embodiment of my invention as disclosed in Figs. 1and 2 of the drawings. The. apparatus as disclosed in Fig. 5 of thedrawings is mounted on any desirable stand or framework, such, forinstance, as that disclosed in Figs. 1 and 2 of the drawings, andconsists of a panel 5| rack and tank of this embodiment of my inventionconsists of a rear transverse compartment l3 similar to that which hasbeen described in connection with the preferred form of my invention.The container supporting and enveloping members which are associated,for heating medium transfer, with the rear transverse tank l3 comprisetransversely spaced curved container receiving and enveloping sections,the front walls of which are formed as in Fig. 1 to provide verticallydisposed compartments l5 spaced apart to provide longitudinal openingsl6 for receiving the ribs 26 of the containers which have the usualcalibrations 29 thereon. It is apparent, therefore, that thecalibrations are visible for observation to indicate the amount of fluidbeing drained from each container. preferably, though notnecessarily, ofthe same type as those hereinbefore described, having at their outletnipples 28 ground glass stopcocks 53 and enlarged glass portions 54providing a visible area for observation of the passage of fluidtherethrough. This arrangement is particularly advantageous in aprolonged transfusion in which the fluid is infused into the patientdrop by drop. The dropping of the fluid being visible through the glassenlargement 54. It happens that I have chosen to show in Fig. 5 of thedrawings the unit B as constituting the support for four containerswhile the unit A is only adapted to receive three containers. It isobvious that they may be enlarged to hold more containers or may be madesmaller to hold fewer containers. The rack and tank units A and B areadapted to receive either a liquid or gaseous heating medium and tooperate on the same principle and by the same apparatus as that whichhas been disclosed in connection with Figs. 1 and 2 of the drawings.

The lower unit B which is about to be described differs in certainfeatures from the combined The containers l2 are rack and tank of theunit A. In this form of combined container rack and tank the usual reartransverse tank I! is utilized with which are containers supporting andenveloping members which comprise pairs of oppositely disposedsemicircular arm members 52. Each pair of these members 52 is spaced onefrom the other to provide an open area or space therebetween. Theopposed supporting and heating medium containing arms 52 are spacedapart to provide the usual opening for the longitudinal projecting ribsof the containers which have the usual calibrations 29 thereon. The openareas between the pairs of container enveloping arm elements 52 of therack and tank provide a space for the passage of rubber or like tubing55 to extend from the upper unit A through and between the lower unit B.An advantageous characteristic of this construction is provided by thisarrangement whereby the tubes 55 carrying the heated fluid from theheated upper containers will pass between the heated pairs of arms 52 inthe lower unit B to thereby aid in retaining the proper temperature inthe fluid flowing from the containers supported in the unit A. Thecontainers I! which are supported in the unit B are of similarconstruction to those hereinbefore described, each having the groundglass stopcock 53 and preferably provided with the enlarged glass por- Otions 54 to which tubing 55 is connected.

I have disclosed various unheated containers attached to the panel 5|such as the burette 56 and the vacuum type thermos bottle 51, each ofwhich is provided with any desirable outlet control means 58 connectedwith the tubing 55. It is within the scope of my invention to use anynumber of heated and unheated containers upon the panel 5|, the typesand number thereof being within the regulation of the attending surgeon.

It is understood, of course, that thermostatic controls and the like areutilized in connection with the units A and B, all as hereinbeforepointed out in connection with the apparatus as disclosed in Figs. 1 and2.

In this form of my invention I provide a multi-fuser or collecting cell59 which is preferably of the double walled thermos bottle type and issuspended from the panel 5i by means of a bracket and is provided with aremovable U ground glass cover 6| having a plurality of nipples or glassentrances 62 extending therefrom for attachment to the rubber tubingwhich extends from the various containers I! supported in the units Aand B. While I have disclosed a glass stopper or manifold member 6|, arubber stopper or one of any other suitable material may be used. At thelower end of the collecting cell 58 I provide an outlet controlled by astopcook 63 opening into an enlarged glass portion 64 constituting aportion whereby the dripping of fluid may be visible. Tubing 55 isconnected to the enlarged portion 64 and is adapted to extend to aneedle or the like implement for infusing the fluid into the recipient.A glass Y fitting 65 may be incorporated in the tube 55 for receivin afurther tube 61 which may be connected with a container disposed in anyconvenient position having therein a saline solution or the like whichmay be used for flushing out the needle.

In the event a single walled glass collecting cell is used instead ofthe preferred thermos bottle type cell I provide different means forcontrolling the temperature of the fluid within the collecting cell 59.In this instance I employ an electronic thermoregulator 58 which isinstalled in any convenient manner within the collecting cell and isprovided with electric connection 69 to a relay. I a

In this form of my invention a greater gravity head may be attained byraising or lowering the panel 5|. Any suitable means may be employed forinfluencing the gravity flow of the fluid.

In Fig. 6 of the drawings I have disclosed an apparatus particularlydesigned for use in a simple blood transfusion. This apparatus consistsof a panel 10 having at its upper end an aperture 1 I A single heatedcontainer rack and heating tank 12 is mounted in any suitable way uponthe panel Ill. The container rack and tank 12 contains a heating mediumof a similar nature to that already described. A valve control outlet 13is provided at the bottom of the container to drain the contents thereofthrough an enlarged visible drip portion 14 which is connected with thetubing 15 which carries the fluid to the patient. It is evident thatsuch a simple unit as this may be suspended by means of the aperture IIon the wall or other convenient place adjacent the bedside of thepatient, and presents a simple apparatus which will control thetemperature and rate of flow oi the fluid from the container l2.

In Fig. '7 of the drawings I have disclosed a collecting cell which ismounted within a casing 33 and which at its upper end is provided with astopper Hi to which is connected through an aperture in the casing atube of double glass tubing 'I'I having an enlarged visible drip portion18 to which is connected for fluid flow a manifold member 19 formed ofsingle or double glass walls and having a plurality of tubes projectingtherefrom for connection with rubber tubing from the containers l2 whichare mounted thereabove within the combined container rack and tank. Suchan arrangement as that disclosed in Fig. '7 of the drawings isadvantageous in instances where it is extremely critical that thetemperaturewithin the multi-fuser casing 33 be retained at an even leveland by this arrangement the casing need not be opened to attach anddetach tubing to the manifold member I9 to allow the fluid to flow intothe multi-fuser. It is also to be noted that this arrangement hasfurther advantages in presenting the tubing for facile and efllcientcleaning thereof.

What I claim is:

1. In a transfusion apparatus, container racks and heating units spacedapart one above the other, a plurality of fluid containers mounted insaid units for controlling the temperature of the fluids within thecontainers, valve controlled fluid outlets associated with each of saidcontainers, a collecting cell mounted below said units and provided withinlets provided by means of tubing with said valve controlled fluidoutlets for the controlled selective flow of fluid from said containersinto said collecting cell, and said tubing connecting the containers insaid uppermost heating unit with said collecting cell passing within theheating range of the heating unit below said uppermost heating unit anda valve controlled heating inlet in said collecting cell.

2. In a transfusion apparatus, a container provided with a projectingrib and adapted to contain and dispense a therapeutic agent, and asupporting and heating unit for said container and the contents thereof,embodying a tank for receiving therein a'heating medium for circulationtherethrough and the walls of said tank arranged to support andsubstantially envelop said container, the tank walls being furtherformed to provide an opening for receiving and exteriorly exposing theprojecting rib on the container, and a valve controlled drainage outletin said container for dispensing the contents thereof.

3. A transfusion apparatus including a container adapted to dispense afluid, a support and and the walls of said tank arranged to support andsubstantially envelop said container, the tank walls being furtherformed to provide an opening to exteriorly'expose a particular portionor the container when the latter is in dispensing position supported bythe tank, and means on said container for engagement with the walls ofsaid tank to retain the container in position supported by the tankexposing the particular porheating unit for said container and thecontents 10 tion thereof, and a fluid outlet in said container.

thereof; embodying a tank for receiving therein a heating medium forcirculation therethrough RALPH A. BUTLAND.

